Provider Demographics
NPI:1871862755
Name:HAMPSHIRE HILLS SPORT & FITNESS
Entity Type:Organization
Organization Name:HAMPSHIRE HILLS SPORT & FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-673-7123
Mailing Address - Street 1:50 EMERSON ROAD
Mailing Address - Street 2:P.O. BOX 404
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055
Mailing Address - Country:US
Mailing Address - Phone:603-673-7123
Mailing Address - Fax:603-673-0797
Practice Address - Street 1:50 EMERSON RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-3516
Practice Address - Country:US
Practice Address - Phone:603-673-7123
Practice Address - Fax:603-673-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty